Do you know how much blood you lose during your period?

I never had a clue. I just knew that it was too much. It made my life difficult for the whole of my period. I need to go to the loo every one and a half hours to change my pad. If that isn’t possible I get really anxious that I’ll leak. On the London Underground I used to stand (despite feeling like I was about to pass out with period pain) rather than risk the embarrassment of bleeding onto the seat.. I often leaked. Sometimes the blood soaked through my tampon or towel, my pants and my clothes. I’ve walked through a packed restaurant in a beautiful duck egg blue shift dress only to discover in the women’s toilets that a large blood stain was showing through my dress. I was mortified.

I’m convinced I’ve been anaemic most of my menstruating life. Almost all the times I’ve had a blood test it showed I was low in iron. I’ve always been pale and often low in energy.

Fortunately, my innate curiosity got the better of me and I found a way to work out exactly how much blood I lose during my period.

Discovering just this one fact about my body changed my life. And it made my heavy periods much easier to manage.

Knowledge is power

I learnt that my periods are what is medically defined as “heavy” and therefore I’m highly likely to be anaemic. I started eating more iron-rich foods and taking high quality iron tablets. I had more energy throughout the whole of my menstrual cycle, not only during my period.

I also worked out exactly which days (or hours to be precise) of my period are the heavy ones. Because I’d not paid much attention previously, my perception had been that it was the whole of my period – which used to be up to 8 days. It felt like a nightmare to be managing that. But when I tracked it for one period, I found that my periods are only actually heavy from about Hour 18 after they start to Hour 48. This shortened the nightmare from 8 days to just under 2 days and made it less horrific to manage.

Then I got to wondering whether every period was the same. I tracked the heaviness of my period for several periods and to my surprise it was like clockwork: always heavy from Hour 18 to Hour 48! The wonderful thing about our periods (and indeed our whole menstrual cycle) is that they tend to follow a pattern: the same or very similar every period And every cycle.

This is incredibly transformative and life-changing information. Knowledge really is power. It means we can use these facts about our bodies to our advantage, to make life easier for ourselves.

In this case it helps us deal with the difficult times, like heavy periods. You can use it for other things to – like I’ve used it to track when my period pain comes.

I now plan my life so that on my 2 heavy days I work from home or stay near home. Of course, that’s not always possible. When I go out, I know that those are my heavy hours and I must be prepared, which pads to take and how many. I keep an eye on my watch to go to the loo every one and a half to two hours. This sounds obvious writing it to you now, but as I’d never given my periods much attention each one had felt like an overwhelming mess that I dreaded and as soon as it came, I wanted it to end.

Now I feel like I know exactly what’s going on and I can handle it. Tracking how much I bleed and when has given me proper understanding and a level of control.

How to work out how much blood you lose during your period

1. If you use a menstrual cup

Provided your menstrual cup has a measuring mark on it, this is the easiest way. You can see how many millilitres of blood are in it each time you take it out. Just make a note somewhere, and at the end of your period add up the total.

2. If you use pads

If you use pads you can use my chart below to roughly convert the amount of blood in your pad to a measurable quantity in millilitres. My chart shows different amounts of blood on different sizes of pad so you can estimate how many millilitres there are. Again, make a note of it somewhere, and at the end of your period add up the total.

3. If you use tampons

I don’t use tampons, so I’ve not produced a chart for them. Regular tampons hold about 5ml and super tampons about 10ml so you can estimate from that. Or check the packet or manufacturer’s website to see how much each tampons holds.

How to work out your heaviest days

The rough-and-ready way is simply to notice which days your period is heaviest. It’s also helpful to refine this a little: morning, afternoon, evening or night.

It’s best to note this alongside your note of the amount of blood in your cup or pad.

To check whether your periods are categorised as heavy there’s a quick and easy questionnaire.

If your periods are heavy and difficult to manage, the more precise you can be about timing the better. If you note the time of day it will enable you to roughly work out your flow rate.

For example, if put you cup in at 7am and empty it at 9am and there’s 7.5ml of blood in it, then that’s 7.5ml of blood lost in 2 hours. If you put it back in a 9am and empty it at 11am and there’s 15ml of blood in it, then that’s 15ml of blood lost in 2 hours. The flow rate for the second two hours is twice as much as for the first two hours.

You don’t need to be exact about it, but this will show you not only how much blood you lose, but also how quickly.

You can use this powerful information to plan your life on your heaviest days so that your heavy periods become easier to live with.

Too complicated?

If this feels too complicated, then just adjust it to make it simple and quick for you. The important thing is to get a good idea of how much blood you lose, and which days are your heaviest.

You don’t need to do this every period. Doing it for just one period will be invaluable but doing it for three periods will enable you to spot patterns.

How to use this to be healthier

The most important thing to gain from this is checking if you might be anaemic.

If you regularly lose more than 80ml (2¾ fl oz) of blood then you may be anaemic (Ruth Gilmore and Uma Dinsmore-Tuli: Anatomy and Physiology notes in course manual for Womb Yoga: Well-Woman Yoga Therapy for Women’s Health and Vitality, 2015).

Anaemia symptoms include tiredness, shortness of breath, a noticeable heart beat and a pale complexion.

It is caused by insufficient iron in the body. Iron is used by our red blood cells to make haemoglobin. It transports oxygen around the body from our lungs to all our organs and cells. They use oxygen as fuel to function optimally. If there’s not enough iron, there’s less oxygen so our organs and cells wont function as well as they should, hence the tiredness.

If you regularly lose more than 80ml (2¾fl oz) then it is advisable to increase your intake of iron in your food. Iron-rich foods iron include:

• dark-green leafy vegetables like watercress and curly kale
• meat
• pulses (beans, peas and lentils)

Tea, coffee, milk and dairy can reduce your absorption of iron so it’s best to eat less of them.

Eating vitamin C alongside iron-rich foods, such as a glass of orange juice, red and green peppers, strawberries and broccoli helps the body absorb iron.

You might also want to take an iron supplement, but you must consult your medical practitioner before doing so.

I take a high-quality one in which the iron is in the same state it is in food. Some supplements contain iron in a different form and there is some debate as to whether our bodies can absorb it. And some iron supplements give rise to side-effects, but I’ve never had any with the food-state iron supplements. It takes several weeks for our body to replace all our red blood cells so, taking iron supplements for a few days each cycle won’t help much.

Please consult a medical practitioner if:

• you have heavy bleeding as it can be a sign of a more serious medical condition
• you think you might be anaemic – you can have a blood test to check your iron (haemoglobin) levels
• before taking any supplements.

How to use this to make your life easier

You can use this powerful information to plan your life on your heaviest days so that your heavy periods become easier to live with. You’ll know which pads you need and when. Or you’ll know how often you need to empty your cup on the different days of your period. You’ll know when it’s best to arrange to stay home or close to home if you can. You’ll know how many hours you can go without being near a loo.

The easiest thing I’ve found for heavy periods is a menstrual cup plus cloth pads. Cups hold more blood than tampons.

The only way I’ve discovered to make my period less heavy is to take it easy and put my feet up. For more period tips download my free ebook Five Ways to an Easier, Nourishing and Restorative Period.

It’s so important to know your own body, what it’s doing and why so that you’re not struggling but you can be at your optimum health and wellbeing.